Please complete the following questions to register for the women's event

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* 1. Please give your name (first name and surname):

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* 2. Email address:

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* 3. Date of birth (optional):

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* 4. Mobile phone number (optional):

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* 5. Where is your local CycleSurgery store?

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* 6. Would you like to hear more about women's events?

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* 7. What sort of cyclist are you?

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* 8. Would you like to be added to the list for regular email updates from any/all of the following? (select as many as you like)

Thank you for your time!

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